Oncobariatrics: Understanding the impact of obesity in cancer care and and improving surgical outcomes

The rising rates of obesity represent a serious public health challenge worldwide. It currently outranks smoking as a leading modifiable risk factor for burden of disease, and is a key contributor to cardiovascular disease, disability and all-cause mortality. It is not surprising that cancer and cancer care are becoming increasingly affected by obesity. Increasing evidence suggests that cancer outcomes are significantly worse for patients with obesity, in all cancer streams including breast, prostate, liver, bladder and colon cancer. Patients who require surgery are at an increased risk of perioperative complications, resulting in longer hospital stays and decreased functional outcomes. Furthermore, obesity presents significant technical challenges, including decreased exposure and challenging tissue handling, leading to worse technical outcomes such as conversion to open procedures, decreased lymph node yield and increased margin positivity. There are few data to support the optimal management of obese patients after a diagnosis of cancer. Questions such as: • How does intentional weight loss after diagnosis affect cancer treatment and outcomes in patients with obesity? • Can we safely and effectively reduce perioperative risk in cancer surgery with weight loss, through lifestyle measures, pharmacological agents or even bariatric surgery? This project will explore the impact of obesity on all aspects of cancer care, stakeholder perceptions of obesity management after a diagnosis of cancer, and investigate how to improve surgical outcomes in patients with obesity and cancer.